CMS Formulary

Displaying 214891-214900 of 1611142 results.
ID: 214891
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214892
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214893
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 214894
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 214895
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214896
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214897
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 849831
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 214898
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 214899
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 214900
Formulary ID: 00021094
Formulary Version: 13
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30